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Older adults that I see are often in pain, and it is alarming to me how many wouldn’t mention it unless directly asked, “do you have pain?”. Obviously, this causes concern for me. I think it is important for seniors and their family or caregivers to recognize when pain is present so they may regularly monitor the pain level. In an article Assessment and Measurement of Pain in Older Adults, authors Keela A. Herr, RN, PhD and Linda Garand, RN, PhD, CS, reference that the high prevalence of unrelieved pain in older adults is thought to be from under recognition and, therefore, under treatment.  

There is a misconception that pain is just part of the aging process. While it is true that seniors often deal with painful diseases and chronic illnesses, the idea that a person should live with pain because they are older is not a valid reason to ignore pain. Many times, older adults don’t want to report their pain because they worry that looking into the pain may determine a new diagnosis or fear they will have to go to the hospital.  

Cognition problems also create a major barrier for reporting and monitoring pain. Seniors with memory problems or dementia may not be able to accurately report the pain or if they do report it, it may not be taken as seriously due to the cognition problem. Often changes in behaviors need to be noticed by a family member or a caregiver to determine that pain could be a problem which means that families and caregivers need to be educated on these changes in behavior and pain indicators. Everyone handles pain differently as well so this is not always an easy task for a caregiver. Behaviors such as agitation, mood changes, crying out with no apparent reason, and unusual sleep disturbances are all reasons to look at whether a person is suffering from pain.

Depression in seniors is common, and a person with depression suffers from pain at a much higher level than if they are not battling depression. This is a very serious problem that should not go untreated. Often when depression is treated properly, the pain can be less and more manageable.  

The current, most universal, system for pain assessment is the number scale. Ask your loved ones to rate their pain from zero to ten, with ten representing the most painful. Self-report of pain is really the most accurate report because every person handles and tolerates pain differently. The important thing is for families and caregivers to ask their loved ones what their pain level is on a regular basis. Make an effort to ask this question and monitor the levels. If the level is always ten and never decreases after a pain treatment, then this is a problem and needs to be addressed. If someone normally reports a pain level of two and one day they report a much higher number, this is also a red flag for concern. If someone is reporting pain and there is no treatment plan at all, this is also a problem.  

Western Illinois Home Health Care provides skilled services trained to provide pain management and oversight. If you or someone you know is suffering with pain, and are in need of in-home services, please call our office at 1-800-228-5993.

Amanda Powell, BSW is Senior Care Manager for Western Illinois Home Health Care

Pain in Older Adults

September 2014

by Amanda Powell